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It is with a great deal of gratitude and sadness I have tendered my resignation as Principal Deputy National Coordinator for Health IT. All of the ONC staff and, for that matter, all of the federal staff with whom I worked, have been more than patient and generous as I entered the world of federal public service.

The goals and objectives of our diverse and important activities helped me understand and accept the challenges, and then embrace them. I was sustained by the spirit and talent that I encountered every step along the way. You’ve heard me say on several occasions that I’ve never seen such a group of dedicated leaders and staff. It is heartwarming and head-pleasing to have worked with all of the federal staff and to represent the providers and patients in the private and public sector who are pulling and pushing us toward a very promising future where the collective efforts will benefit the nation and the world. The people and the progress are awe inspiring. It’s been a privilege to have played any role in such a truly transformative era, much less a leadership role in all the successes we have achieved both inside and outside ONC.

I look forward to continuing to support HHS’ vision of achieving interoperability and better engaging patients from the private sector. With many wonderful memories and much gratitude, David

David S. Muntz, CHCIO, FCHIME, LCHIME, FHIMSS

Principal Deputy

HHS/Office of the National Coordinator

Also last night, Mostashari announced that Dr. Jacob Reider, director of the ONC Office of the Chief Medical Officer, will serve as acting national coordinator and Lisa Lewis, currently deputy national coordinator for operations, will be acting principal deputy, effective Oct. 4. Joy Pritts will remain as chief privacy officer and political appointee, Mostashari noted.

Mostashari also said that Muntz informed him “several weeks ago of his decision to return to the private sector to work more closely on the front-lines of medicine.”

I shall not make any further predictions about next full-time coordinator.

On Friday, I called out physician social network Sermo for its “Pro Football Injury Challenge.” Someone fr0m the company was watching, even over the weekend, because Sermo put up a response on its blog on Sunday, apologizing for “insensitive language” in the original e-mail that led to, as the unnamed blogger put it, an “unfortunate misinterpretation” that “we were asking doctors to predict future player injuries.”

According to Sermo, the Pro Football Injury Challenge “was intended solely for physicians to aggregate data like the PBS study performed last pro football season, which exposed and quantified the true magnitude of player injuries in the NFL.” The post continued:

The focus of this Challenge is to aggregate physician opinion around injury recovery, with frank supporting discussions on trending topics in the sport (e.g., concussions) being hosted on Sermo. By collecting physician opinion on how concussions (in the aggregate) are trending in pro football, we are complementing and expanding the clinical discussion prior to the upcoming PBS Special, League of Denial: The NFL’s Concussion Crisis. Contrary to what has been reported, we have not nor would we ever design a game that rewards predictions of injury or illness to any individual, nor are we seeking to exploit, de-humanize or profit from these patients, their loved ones or their caregivers.

The rationale behind the Challenge is, has been, and will be to help decrease the number, severity and recurrence of all sports-related of injuries by eliciting physicians’ opinions on proper injury recovery periods and methods.

OK, Sermo, you have earned the benefit of the doubt for now. I hope the physician community holds you to your word.

Free, mobile ambulatory EHR developer DrChrono made a minor ripple of news this week, claiming to be the first vendor to release an EHR for the new Apple iOS 7. But that’s not why I’m writing this post. I’m calling out DrChrono co-founder and COO Daniel Kivatinos for this tweet:

Indeed, the HITECH Act and Meaningful Use are about the Triple Aim of producing safer care, improving population health and lowering overall healthcare costs. The incentive money isn’t supposed to make physicians rich or even cover the cost of the typical EHR. (Yes, “free” EHRs have costs in terms of changing physician workflows and interfacing with practice management systems, and the advertising may cause patients to lose trust in their doctors, as John Lynn seems to have found with Practice Fusion.) Frankly, I don’t want to go to a doctor who views Meaningful Use as “cashing in.” That’s not “meaningful” in the spirit of the incentive program.

I’m making a big deal out of this because this is not the first time DrChrono has made misleading and hyperbolic statements. As I wrote a couple years ago, the company claimed its patient check-in app was “groundbreaking,” despite a lot of evidence to the contrary. The same post also had a video from DrChrono in which the vendor explained to physicians how they could qualify for Meaningful Use “tax breaks.” The incentive payments aren’t tax breaks. In fact, the money counts as taxable income.

The video is still up on YouTube, and it’s been viewed more than 57,000 times. That’s 57,000 times people have heard a patently false statement. DrChrono, stop misleading clients or you won’t have any clients left to mislead.

Also from the “what were they thinking?” department, physician social network Sermo marked the start of the NFL season this month with the launch of the “Pro Football Injury Challenge.” I know this because I received this e-mail:

Yes, I know I’m not a doctor. Sermo sent a follow-up a few days later saying that I received the invitation in error. But actual physicians still are competing against each other in kind of a fantasy football injury pool. Do you find this as tasteless as I do?

Last week, I joined Steve Dean of Falls Church, Va.-based Inova Health System’s Inova Telemedicine Program on stage at the American Telemedicine Association’s Fall Forum in Toronto for what turned out to be a very well-received session on mobile apps and devices finding their way into clinical workflows. It was either a Letterman-style top 10, or, as Dean described it, a Siskel and Ebert-style discussion and review of 10 popular and/or interesting apps.

In one example, Dean noted that Aetna’s iTriage consumer app had been downloaded more than 9.5 million times. One audience member questioned the relevance of that number, suggesting that many people download an app, try it once and decide not to use it again. She asked if we had any actual usership statistics. I said I would contact Aetna and find out, then post the answer here on this blog.

An Aetna spokeswoman didn’t have data on the number of iTriage users, but told me that iTriage has nearly 60 million user sessions per year. (For what it’s worth, the app also passed 10 million downloads last week, she added.)

Here are our slides from that presentation. We alternated, with Dean presenting AirStrip OB, AliveCor, Asthmapolis (which changed its name last week to Propeller Health), iTriage and Welldoc. I opened discussion on DrawMD, mym3, Walgreens, Fitbit and various apps from the VA and CMS. Download ATA Fall 2013 v3.pdf

I realize context might be missing from just looking at these slides, but the ATA tells me video will soon be available online through the ATA Learning Center. (For now, access is restricted to ATA members, but the site promises non-member access “soon.”)

I don’t have any inside knowledge about whom the White House might be considering to replace Dr. Farzad Mostashari when he steps down from his post as national health IT coordinator on Oct. 5, but I get the sense Principal Deputy National Coordinator David Muntz will at least be acting head of the Office of the National Coordinator for Health Information Technology. What makes me think this?

I’ve just had my first story published in a major national magazine, or at least the online version of one, namely US News and World Report. It’s about patient engagement strategies for hospitals and medical practices in the context of EHRs, for the magazine’s “Hospital of Tomorrow” feature, and I’m getting good feedback so far. Needless to say, I’m pretty excited. Check it out here.

Free Healthcare IT Newsletter Want to receive the latest news on EMR, Meaningful Use,
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